- UPMC (Pittsburgh, PA)
- …oversight of the day-to-day operations of the authorization, denial management, and/or utilization review functions of UPMC Revenue Cycle, involving both ... Purpose: UPMC is hiring a full-time Clinical Manager , Revenue Cycle CCM to support the Pre-Arrival...as a resource person for authorization, denial management and/or utilization review processes. + Assess and respond… more
- J&J Family of Companies (Rochester, NY)
- …States **Job Description:** We are searching for the best talent for Account Manager to be in Rochester/Syracuse, NY. **About Surgery** Fueled by innovation at the ... their journey to wellness. Learn more at https://www.jnj.com/medtech As a Field Sales Account Manager , this individual will serve as the point person for end to end… more
- Cabinet Peaks Medical Center (Libby, MT)
- …Services, Laboratory Services, Nutrition and Diabetes Education, Quality Risk Management, Utilization Review and Risk Management, Employee Health Education, ... Cabinet Peaks Medical Center is looking for a Nurse House Manager to join our Nursing Administration Team! The Nurse House Manager is responsible for the overall… more
- The County of Los Angeles (Los Angeles, CA)
- EQUITY IN COUNTY CONTRACTS PROGRAM MANAGER (ADMINISTRATIVE MANAGER 10, ISD) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4613521) Apply ... EQUITY IN COUNTY CONTRACTS PROGRAM MANAGER (ADMINISTRATIVE MANAGER 10, ISD) Salary $119,695.68 - $161,306.16 Annually Location Los Angeles County, CA Job Type… more
- BronxCare Health System (Bronx, NY)
- …and department staff when prevented from completing job tasks. -Assists the Administrative Manager and Director with annual review and revisions of departmental ... Overview The Appeals Manager is responsible to assist in the analysis...the department's leadership develop strategies for denial prevention, improved utilization management, documentation of medical necessity and identify patterns… more
- Sutter Health (San Francisco, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Working ... Center Davies **Position Overview:** Conducts preauthorization, concurrent, and retrospective utilization management review using the department's accepted… more
- Highmark Health (Pittsburgh, PA)
- …Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory ... etc. Serves as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer guidelines. Adheres to… more
- CenterWell (Hope, AR)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... community and help us put health first** The **Clinical Manager ** coordinates and oversees all direct care patient services...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient ... for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use,… more
- Access Dubuque (Dubuque, IA)
- …also available remotely. **Key Responsibilities:** + Provide telephonic case management and utilization review for assigned consumers. + Develop, implement, and ... Bilingual RN Case Manager **Cottingham & Butler/ SISCO** 1 Positions ID:...Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred. + **Skills:**… more